{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,6]],"date-time":"2026-10-06T01:49:28Z","timestamp":1791251368357,"version":"4.1.0"},"reference-count":38,"publisher":"Springer Science and Business Media LLC","issue":"8","license":[{"start":{"date-parts":[[2023,6,10]],"date-time":"2023-06-10T00:00:00Z","timestamp":1686355200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2023,6,10]],"date-time":"2023-06-10T00:00:00Z","timestamp":1686355200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"name":"Universit\u00e4tsklinik M\u00fcnchen"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Ann Hematol"],"published-print":{"date-parts":[[2023,8]]},"abstract":"<jats:title>Abstract\n<\/jats:title><jats:p>We sought to evaluate the role of extramedullary disease (EMD) in sequential RIC retrospectively analyzing data of 144 high-risk AML patients undergoing HLA-matched transplantation. Median long-term follow-up was 11.6\u00a0years. Eighteen percent of patients (<jats:italic>n<\/jats:italic>\u2009=\u200926\/144) presented with extramedullary AML (EM AML) or a history of EMD at time of transplantation. Overall relapse rate was 25% (<jats:italic>n<\/jats:italic>\u2009=\u200936\/144) with 15% (<jats:italic>n<\/jats:italic>\u2009=\u200921\/144) of all patients developing isolated BM relapse and 10% (<jats:italic>n<\/jats:italic>\u2009=\u200915\/144) developing EM AML relapse with or without concomitant BM relapse (EM\u2009\u00b1\u2009BM). Manifestation of EM relapse after transplantation occurred frequently at multiple sites and presented mostly as solid tumor mass. Only 3\/15 patients with EM\u2009\u00b1\u2009BM relapse showed a prior EMD manifestation. EMD prior to allogeneic transplantation had no impact on post-transplant OS when compared to non-EMD (median post-transplant OS 3.8\u00a0years versus 4.8\u00a0years; ns). Risk factors (<jats:italic>p<\/jats:italic>\u2009=\u2009\u2009&lt;\u20090.1) for EM\u2009\u00b1\u2009BM relapse included younger age and a higher number of prior intensive chemotherapies, whereas the presence of chronic GVHD was a protective factor. Median post-transplant OS (15.5\u00a0months vs. 15.5\u00a0months), RFS (9.6\u00a0months vs 7.3\u00a0months), and post-relapse OS (6.7\u00a0months vs. 6.3\u00a0months) were not significantly different between patients with isolated BM vs. EM\u2009\u00b1\u2009BM relapse. Taken together, occurrence of EMD prior to as well as of EM\u2009\u00b1\u2009BM AML relapse after transplantation was moderate, presenting mostly as solid tumor mass after transplantation. However, diagnosis of those does not seem to influence outcomes after sequential RIC. A higher number of chemotherapy cycles prior to transplantation was identified as recent risk factor for EM\u2009\u00b1\u2009BM relapse.<\/jats:p>","DOI":"10.1007\/s00277-023-05281-8","type":"journal-article","created":{"date-parts":[[2023,6,10]],"date-time":"2023-06-10T06:01:38Z","timestamp":1686376898000},"page":"2213-2223","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Impact of extramedullary disease in AML patients undergoing sequential RIC for HLA-matched transplantation: occurrence, risk factors, relapse patterns, and outcome"],"prefix":"10.1007","volume":"102","author":[{"given":"Alessia","family":"Fraccaroli","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniela","family":"Vogt","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Margarete","family":"Rothmayer","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Karsten","family":"Spiekermann","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2220-2346","authenticated-orcid":false,"given":"Friederike","family":"Pastore","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Johanna","family":"Tischer","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2023,6,10]]},"reference":[{"issue":"8","key":"5281_CR1","doi-asserted-by":"publisher","first-page":"1083","DOI":"10.1038\/bmt.2017.8","volume":"52","author":"B Gyurkocza","year":"2017","unstructured":"Gyurkocza B, Lazarus HM, Giralt S (2017) Allogeneic hematopoietic cell transplantation in patients with AML not achieving remission: Potentially curative therapy. 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